| Methods | RCT parallel group | |
| Participants | n = 66 patients in Home-based CR group (33 in brief exercise programme subgroup & 33 inextended subgroup); n = 61 patients in Centre-based CR group (31 in brief subgroup & 30 in extended subgroup); 100% uncomplicated acute MI; mean age 52 (SD 9); 100% male Inclusion: Uncomplicated AMI (elevated serum creatinine kinase or oxaloacetic transamianase, prolonged chest pain consistent with AMI, new Q waves or evolutionary ST changes in ECG) Exclusion: Unable to undertake exercise test, congestive heart failure, unstable angina pectoris, valvular heart disease, atrial fibrillation, bundle branch block, history of bypass, stroke, orthopaedic abnormalities, peripheral vascular disease, chronic pulmonary obstructive disease, obesity |
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| Interventions |
Home-based CR (intervention): Exercise: Overall duration: 8 wks (brief) or 23 wks (extended), Frequency: 5 sessions/wk; Duration: 30 mins/session; Intensity: 70-85% HRmax; modality: stationary cycling. Portable heart rate monitors & teletransmissions of ECG; 2 phone calls/wk by staff to verify training intensity, clinical status and medication Other: No education or psychological intervention reported Centre-based CR (control): Exercise: Overall duration: 8 wks (brief) or 23 wks (extended), Frequency: 5 sessions/wk; Duration: 60 mins/session; intensity: 70-85% HRmax; modality: walking/jogging. Group based & supervised Other: No education or psychological intervention reported |
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| Outcomes | Exercise capacity; mortality & cardiovascular morbidity | |
| Follow up | 23 weeks post randomisation | |
| Subgroup analyses | Yes. Results reported according to the two subgroups reported i.e. brief vs extended exercise training | |
| Country & settings | USA, single hospital centre | |
| Notes | Results of two subgroups included into analysis separately | |
| Risk of bias | ||
| Bias | Authors’ judgement | Support for judgement |
| Adequate sequence generation? | Unclear risk | Not reported |
| Allocation concealment? | Unclear risk | Not reported |
| Blinding? All outcomes |
Unclear risk | Not reported |
| Incomplete outcome data addressed? All outcomes |
Low risk | Drop out reported. No imputation of missing data discussed. Effect of incomplete outcome data likely to be small |
| Free of selective reporting? | Low risk | All outcomes described in the methods section are reported in the results |
| Groups balanced at baseline? | Unclear risk | Baseline characteristics not reported |
| Intention to treat analysis? | Low risk | Term ‘intention to treat analysis’ not stated directly, but results appear to be presented according to original random allocation. This is further supported by a trial flow diagram in the paper |
| Groups received same intervention? | Low risk | Both home and centre groups were very closely balanced in terms of the exercise training received |